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Your guide to vaccinations

Thursday 13th November

Many people are in the habit of visiting their GP's surgery for a flu jab each year. But with so many different inoculations available these days, which do you and your family really need? Wendy Golledge reports.

With the MMR never far from the headlines and questions being raised about “herd immunity” (i.e. community-wide immunity), no wonder some people are wary of vaccines. However, for Catherine Moore, principal clinical scientist in molecular virology at Public Health Wales, there is no real debate. “Ultimately, vaccination has saved millions of lives,” she says. “Apart from sanitation, immunisation has made a greater difference to public health than any other factor.”

Flu jab

What’s it for? Flu is highly infectious, spreads rapidly and causes fever, chills, aches and exhaustion. It can make you seriously ill and, because it’s a virus, antibiotics won’t help.

Who’s it for? If you’re over 65,pregnant, or have an underlying health condition, flu can quickly develop into a life-threatening condition such as pneumonia, so the jab is offered to everyone in these categories. Children can develop a very high fever or complications such as bronchitis, so in September 2013 a nasal spray vaccine was introduced for two- to three-year-olds.

“Children are walking germs!” says Catherine. “They’re very good at spreading flu as they sneeze everywhere and don’t use tissues. Immunisation not only protects the child, it also stops them spreading flu to their family and vulnerable friends.”

Why should you have it? The flu vaccine protects against three strains of the virus. “Each year, viruses most likely to cause flu are identified by the World Health Organization (WHO) and vaccines are made to match them as closely as possible,” explains Catherine. “While the flu jab won’t ever be100 per cent effective, if you do succumb after vaccination, it’s likely to be much milder and shorter lived.”

MMR

What’s it for? “The MMR protects against three childhood illnesses – measles, mumps and rubella (German measles),” explains Catherine. “We don’t give weight to their seriousness in the UK, but these diseases kill thousands of children worldwide every year.”

Who’s it for? The MMR is offered to children at 13 months, with a booster at school.

Why should you have it? It’s 16years since Andrew Wakefield linked the MMR inoculation to autism and Crohn’s disease, yet the debate rumbles on. In 2010 his study was retracted by The Lancet, as uncorroborated and fatally flawed, and subsequent studies have found no evidence of a link. However, parents’ continuing reluctance to give their children the jab means the UK’s herd immunity has been affected, resulting in the outbreak of a measles epidemic in Wales last year.

“The study caused an immense amount of damage,” says Catherine. “I was involved in last year’s epidemic; we had 1,200 cases, and one death, which could have been prevented. Measles is a systemic illness which affects your child’s internal organs – you can’t trivialise it as just a rash. The MMR is safe, effective and essential. There’s no reason not to have it and it’s never too late for your children – or you – to have it.”

HPV

What’s it for? The human papilloma virus (HPV) vaccine protects against cervical cancer, the second most common cancer in women under 35.

Who’s it for? In 99 per cent of cases, cervical cancer is linked to a history of infection with HPV, so the vaccine protects girls from the virus before they’re exposed to it.

Why should you have it? HPV is very common and easily spread through sex. In most cases the virus does no harm but some high-risk strains are associated with cervical cancer, so for young girls it’s definitely worth being immunised. And what about older women? “HPV is so prevalent – there are over 100 types – it’s likely we’ll all meet it at some point,” says Catherine. “If you’re in your early 20s and have only had one partner, it may be worth getting immunised, but older sexually active women can still protect themselves by having regular cervical smear tests, which detect abnormal cells in your cervix before they can progress to cancer.”

Shingles vaccine

What’s it for? One in four of us will get shingles at some point in our lives. It’s an infection of a nerve caused by the chickenpox virus, which creates a painful rash and itchy blisters on the surrounding skin and is most common in the over 70s.

Who’s it for? Chickenpox remains dormant in the nervous tissues but can reactivate. No one knows exactly why, but it’s thought to be due to a lowered immune system. The shingles vaccine was introduced in September 2013 and is now offered to everyone aged 70. There’s also a catch-up programme for people aged 79 and, as of autumn this year, aged 78. Over the next few years the programme will be expanded to everyone in their 70s.

Why should you have it? The vaccine boosts your own antibodies and prevents half the cases of shingles. Should it still occur, risk of pain is cut by two thirds and the condition is much milder. “Not everyone will get shingles, but having the jab as soon as you’re offered it could reduce your risk of being left with long-term nerve pain if you do,” says Catherine.

Fact file: shingles

The most common side-effect of shingles is post-herpetic neuralgia. This nerve pain can last for months after the rash recedes.

Shingles can’t be cured, but painkillers and antivirals can help to control the pain.

Those waiting for the jab aren’t at an increased or significant risk, as not everyone will get shingles.

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